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DR. NICOLE JOSETTE BOARDMAN MITCHAM MD, MPH
NPI 1154016533
Internal Medicine in Phoenix, AZ

Active since April 10, 2023PECOS Enrolled
2525 E ROOSEVELT ST, PHOENIX, AZ 85008(833) 855-9973 Get Directions Write a Review

NPPES record last updated: June 23, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 4, 2024, Apr 10, 2023 (2 updates tracked since 2023).

About Dr. Nicole Josette Boardman Mitcham Md, Mph NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. NICOLE JOSETTE BOARDMAN MITCHAM MD, MPH (NPI 1154016533) is an individual internal medicine provider in Phoenix, Arizona, licensed in Arizona (79944) and active in the NPI registry since April 2023. She is enrolled in Medicare PECOS and maintains a secondary practice location in Phoenix.

NPPES Registry Identity

NPI1154016533
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. NICOLE JOSETTE BOARDMAN MITCHAMCredential: MD, MPH
Location Address2525 E ROOSEVELT STPhoenix, AZ 85008-4948
Mailing Address2525 E Roosevelt StPhoenix, AZ 85008-4948
Phone(833) 855-9973
Sole ProprietorNo
Enumeration DateApril 10, 2023
Last NPPES UpdateJune 23, 20262 updates tracked since enumeration
NPPES CertifiedJune 23, 2026
✔ NPI 1154016533 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in AZ · 79944
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
2525 E ROOSEVELT ST, Phoenix, AZ 85008
Open in Google Maps ↗

Secondary Practice Location 1

Location 12601 E Roosevelt StPhoenix, AZ 85008-4973 · Phone (602) 344-5011

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Nicole Josette Boardman Mitcham Md, Mph is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85008 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$127.71 typical visit price
range $55.44 – $168.60
Typical copayment $31.92 (range $13.86 – $42.15)
Most-billed visit code 99204
Established Patient
$98.00 typical visit price
range $17.72 – $137.41
Typical copayment $24.50 (range $4.43 – $34.35)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
2525 E ROOSEVELT ST
PHOENIX, AZ 85008
Maricopa County (602) 344-8180
DR. SALIL V. PRADHAN MD
Pediatrics
2525 E ROOSEVELT ST
PHOENIX, AZ 85008
Maricopa County (602) 344-5404
SHEETAL K CHHAYA D.O.
Internal Medicine (Rheumatology)
2525 E ROOSEVELT ST
PHOENIX, AZ 85008
Maricopa County (602) 344-5027
DR. PAUL ANTHONY REYES DEL PRADO M.D.
Surgery
2525 E ROOSEVELT ST
PHOENIX, AZ 85008
Maricopa County (602) 344-1015
DR. MICHELLE DWULIT M.D.
Internal Medicine
2525 E ROOSEVELT ST
PHOENIX, AZ 85008
Maricopa County (602) 344-5146
MALKIA YUSSUF
Nurse Practitioner (Family)
2525 E ROOSEVELT ST
PHOENIX, AZ 85008
Maricopa County (602) 344-1015
SUSAN GEREN MD
Pediatrics
2525 E ROOSEVELT ST
PHOENIX, AZ 85008
Maricopa County (602) 470-5043
WALTER SCHELL MD
Surgery (Vascular Surgery)
2525 E ROOSEVELT ST
PHOENIX, AZ 85008
Maricopa County (602) 344-1015

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Boardman Mitcham's NPI number?

The NPI number for Nicole Boardman Mitcham is 1154016533. It was assigned to this individual provider in the NPPES registry on April 10, 2023.

Where is Nicole Boardman Mitcham located?

Nicole Boardman Mitcham practices at 2525 E Roosevelt St, Phoenix, AZ 85008. The listed phone number is (833) 855-9973.

What is Nicole Boardman Mitcham's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Nicole Boardman Mitcham enrolled in Medicare?

Yes. Nicole Boardman Mitcham is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Nicole Boardman Mitcham was last updated on June 23, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.